Use of gloves

A nurse was concerned about the hygiene knowledge at the nursing home where her father lives. She claimed that several staff members had poor or very poor knowledge of how and why gloves should be used.

Many employees first took care of the lower toilet and then continued to assist the resident without changing gloves. They seemed to believe more that the gloves were to protect themselves rather than the resident. They could also put on gloves to comb hair or adjust clothes.

Infection control is becoming increasingly important. The number of people carrying resistant bacteria is increasing. The spread of infection in healthcare environments is a recurring problem and in Europe, the number of people dying as a result of infections that cannot be treated is increasing. To reduce the spread of infection, healthcare personnel working in patient-related work should wear short-sleeved work clothes. Watches and rings must not be worn on arms and hands. Nails should be cut short. It is not allowed to wear nail polish. When working involves the risk of contact with body fluids, protective gowns or plastic aprons, and gloves should be used.

Hands should always be sanitized before and after contact with the patient. When dirty work is done, hands should be washed before they are sanitized. To maintain good hand hygiene among the residents, many of the elderly need help washing their hands under running water. This is needed both in connection with morning toilet use and at other times in connection with toilet visits. This is often neglected in many places. It is also important that the residents have trimmed and clean nails to prevent injuries and the spread of infection.

It is good if there is hand sanitizer available near the dining area so that the elderly can sanitize themselves. At signs of stomach flu and if someone gets diarrhea or vomiting, the sick person should be isolated from others. If winter vomiting disease caused by Noro- or Rotavirus is suspected, the entire unit should be isolated until tests have shown otherwise. Relatives are advised in these cases not to come and visit their loved ones. Special regulations for food hygiene apply during food handling. The operations should have a self-control program to ensure that food is handled in a safe manner, including regarding keeping food warm.

For those who do not know, gloves are used to protect the elderly from dangerous infections. Therefore, it is important to wear gloves when in contact with body fluids, but otherwise, gloves are not considered necessary to use.

New employees do not always receive adequate introduction to their work and therefore do not understand the importance of adhering to certain routines. The introduction needs to be followed up. Many operations do self-assessments when it comes to how employees work with hygiene, but these instruments do not capture those employees who lack knowledge about the importance of following hygiene routines.

Basic knowledge of infection control reduces suffering and saves time and money

A nursing assistant describes that there is no time to teach basic knowledge about hygiene, etc. to newly hired substitutes. The nursing assistant said "unfortunately many substitutes have to learn these routines themselves". Sometimes the lack of introduction can cause extra costs. For example, it happens that washing labels are flushed down the toilet and cause blockages. The nursing assistant also states that it seems to be more important to teach the substitutes complicated schedule systems and control apps than that the staff performs work in a safe way for the elderly. The introduction is too short and more often than not it is ignorant or relatively new employees who are supposed to introduce the substitute. She further tells about many who have worked for a while assume that "everyone knows that", but it doesn't work that way, she emphasizes. She has also caught colleagues pouring soap into the washing basin and then not rinsing it off with clean water, but only wiping off the foam. This nursing assistant finally gave up and quit when she encountered resistance when pointing out various shortcomings.

Summary - use of gloves

The use of gloves in elder care and health care is crucial to ensure both caregivers' and patients' safety and hygiene. Here are some important steps to ensure the correct use of gloves:
Use gloves at the right times: Gloves should be used during all activities that involve direct contact with body fluids, blood, wounds, or when handling infectious material. They are also used during certain hygienic tasks such as helping a patient with personal hygiene.
Hand washing: Before you put on gloves, it is important to wash your hands thoroughly with soap and water. Hand washing is crucial to reduce the risk of bringing in dirt or bacteria when gloves are used.
Correct size: Use gloves that fit properly. Too big or too small gloves can be uncomfortable and increase the risk of injury or contamination.
Single use: Gloves in health care and elder care should generally be single-use or disposable. Never use the same pair of gloves for different patients or for different tasks. The gloves are primarily there to protect the elderly from your bacteria.
Correct donning: Put on the gloves carefully and avoid touching surfaces or objects that are not sterile with the gloves.
Change when needed: Change gloves if they are dirty, damaged, or if you change task or patient. Do not use the same gloves to handle different matters.
Correct removal: Remove the gloves carefully without touching the outer side of the gloves. Use one hand to grab the inside of the other glove and pull it off. Repeat the process for the other hand.
Wash your hands again: After you have removed the gloves, wash your hands thoroughly with soap and water. This reduces the risk of spreading infection.
Follow workplace guidelines: Follow the specific guidelines and protocols of the workplace for the use and disposal of gloves. This may include proper waste management for used gloves.
Training and updating: Healthcare personnel should regularly be trained on the correct use of gloves and hygiene routines.

Correct use of gloves is an important part of safety and hygiene in elder care and health care. It reduces the risk of spreading infection and protects both health care personnel and patients. Following good hygiene habits and knowing the workplace guidelines for gloves is crucial. Training in infection control must be an obvious part of the introduction of new employees.

Care personnel:
- How do you help each other to do the right thing?
- Do you have a good and well-thought-out introduction program at your unit?
- Do you get the time you need to introduce new colleagues?
- Who gets to do the introduction, is it the most experienced or just the one working the day the substitute arrives?
- Do you have work clothes with short sleeves?
- Does anyone wear rings or watches on their hands?
- Are their nails well cared for?
- Does anyone wear nail polish?
- Is the hair short or tied up?

Manager, nurse, occupational therapist, and physiotherapist:
- How do you ensure that those who work with the residents have the knowledge required?
- Do you have a well-worked-out introduction program where the newly hired get the introduction required?
- Do you have a dialogue and co-planning in the group so that you all have the prerequisites to do your part of the introduction?
- What are your thoughts on delegations, lift training, information about MTP, etc.?
- Do you ensure that the employee has gone through the entire introduction before they are allowed to work on the unit?
- How do you work to follow up that the employees really understand the importance of following the hygiene routines?

Relatives and residents:
- Do you feel safe that the employees at the unit have good knowledge of infection control?

Erland Olsson
Specialist nurse
Sofrosyne - Better care every day